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Druises of the optic disc
Last reviewed: 23.04.2024
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Drusy disk (hyaline body) - consisting of hyaline-like calcifications material in the thickness of the optic disc. Clinically present in about 0.3% of the population and are often bilateral. Only a minority of family members have drusen discs, but almost half have abnormal disc vessels and a lack of physiological excavation.
Clinical Features
Deep Druze. In the early childhood druses can be difficult to detect, because lie deeper than the surface of the disk. With this arrangement, they can simulate a stagnant disk. The symptoms of Druse Disk can be:
- A propelling disc with a scalloped edge without physiological excavation.
- Absence of hyperemia of the disk surface.
- Surface vessels are not hidden, despite the distance of the disk.
- An abnormal vascular pattern that includes early branching, an increase in the number of large retial vessels and the tortuosity of the vessels.
- Spontaneous venous pulse can be present in 80% of cases.
Superficial druses. Usually in early adolescence druses appear on the surface of the disc as waxy pearly irregularities.
Complications are rare.
- In a small number of patients, visual disturbances appear as a result of juxtapapillary choroidal neovascularization.
- Occasionally, there may be a change in the visual fields according to the type of defect of the bundle of nerve fibers.
Concomitant diseases: retinitis pigmentosa, angioid lines, Allagille syndrome.
Special researches
To diagnose drusen disc may be necessary:
Ultrasonography is the most accessible and case-based method. Is able to detect calcifications. Druses can be seen because of their high echogenicity.
CT is less sensitive than ultrasonography, and can miss small druses. Druses can accidentally show up in a CT scan performed on another pathology.
The FAG is useful as follows:
Superficial druses give the phenomenon of autofluorescence preceding the introduction of contrast, and late local hyperfluorescence due to staining. However, these phenomena can not be seen with deep druses, weakening the covering tissues.
The phage with a stagnant disc shows increasing hyperfluorescence and later percolation.
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